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• Technical Article •
Feasibility of reduced dose of 18F-FDG during chest PET/MR examinations
GU Haifeng  LI Ang  CAI Jun  ZHANG Longjiang 

DOI:10.12015/issn.1674-8034.2025.08.018.


[Abstract] Objective To investigate whether the dose of 18F-fluorodeoxyglucose (18F-FDG) used in chest positron emission tomography/magnetic resonance (PET/MR) examinations can be reduced while ensuring image quality and diagnostic accuracy.Materials and Methods A total of 118 patients with abnormal radionuclide accumulation lesions who underwent 18F-FDG chest PET/MR examination (injected dose of 3.70 MBq/kg) using SIGNA PET / MR in the General Hospital of Eastern Theater Command between March 2022 and August 2023 were retrospectively analyzed. Five different PET acquisition times (20 min, 10 min, 5 min, 2 min, 1 min) were used to retrospectively reconstruct the list-mode (list) data, which were used to simulate 100%, 50%, 25%, 10%, and 5% 18F-FDG injection dose, named as G100, G50, G25, G10, and G5 groups. The overall image quality of the five groups was subjectively scored on a 5-point Likert scale, and the Friedman test was used to compare the differences between the groups. Objective analysis metrics included maximum standardized uptake value (SUV) (L-SUVmax), mean SUV (L-SUVmean), and standard deviation (L-SUVsd) of the lesions SUV, standard deviation of background SUV (B-SUVsd), signal-to-noise ratio of the lesions (L-SNR), image noise ratio (IN), and L-SUVmax relative to background noise ratio (LBR), and the differences of the metrics between groups were compared using the One-Way Repeated Measures ANOVA, with post hoc inter-subgroups analyses using Bonferroni correction. G100 served as the reference for the other 4 groups to assess their lesion detectability.Results Higher 18F-FDG doses also resulted in higher subjective scores in all 5 groups (P < 0.05). G25, G50, and G100 had high image quality to satisfy clinical diagnostic needs (all scores > 4). The L-SUVmax, L-SUVmean, L-SUVsd, IN and LBR decreased with the increase of 18F-FDG dose in each dose group, and the difference was statistically significant (all P < 0.05), and L-SNR decreased with the 18F-FDG dose increased, and the difference was also statistically significant (P < 0.05). In post hoc inter-subgroups analyses, there was no significant difference in G25, G50 and G100 between any two groups at L-SUVmax and L-SUVsd (all P > 0.05), but there was significant difference between any other two groups (all P < 0.05). There was no significant difference in L-SUVmean and L-SNR between G5 and G10 groups or between G25, G50 and G100 groups (all P > 0.05), and there was significant difference between the other two groups (all P < 0.05). There were significant differences between any two groups in IN (all P < 0.05). There was no significant difference between G5 and G10, G25 and G100, G50 and G100 on LBR (all P > 0.05), and there was significant difference between any other two groups (all P < 0.05). With G100 as the reference, the missed detection rates in G50, G25, G10 and G5 groups were 1.4%, 2.4%, 4.4% and 6.8%, respectively.Conclusions Using SIGNA PET/MR, if the PET scan time of the chest 18F-FDG PET/MR examination is 20 min, the 18F-FDG injection dose can be reduced from 3.70 MBq/kg to 0.93 MBq/kg, and the dosage is reduced by 75%, which will not affect PET image quality and quantitative assessment results.
[Keywords] lung nodule；non-small cell lung cancer；18F-fluorodeoxyglucose；standardized uptake value；low dose；positron emission tomography；magnetic resonance imaging

GU Haifeng   LI Ang   CAI Jun   ZHANG Longjiang*  

Department of Radiology, Affiliated Jinling Hospital, Medical School of Nanjing University (General Hospital of Eastern Theater Command), Nanjing 210002, China

Corresponding author: ZHANG L J, E-mail: kevinzhlj@163.com

Conflicts of interest   None.

Received  2025-05-14
Accepted  2025-07-31
DOI: 10.12015/issn.1674-8034.2025.08.018
DOI:10.12015/issn.1674-8034.2025.08.018.

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